Cancer - 650,000 Lives Miscalculated
On May 27th, the American Cancer Society announced that 650,400 U.S. cancer deaths were avoided from the early 1990s through 2005. The headline on their release was Cancer Death Rates Steadily Declining. As might be expected, the media promptly picked up the story, and ran it over and over again with virtually identical headlines:
- More Than 650,000 Cancer Deaths Avoided, by MedicineNet.com
- More Than 650,000 Cancer Deaths Avoided, by WebMD.com
If you read the stories, you learned tidbits of information such as:
- The decline in cancer death rates has been greater for some groups than for others
- People with more education generally had bigger declines in their cancer death rates
- Access to cancer screening and medical care is part of the reason for that discrepancy
But overall, what you learned from reading the story or listening to it on the news is that 650,000 lives have been saved over the last 15 years and that the drop is driven in large part by better prevention, increased use of early detection practices, and improved treatments for cancer.
This is thrilling, exciting, and, oh yes, absolutely unsupported by the evidence at hand. With that in mind, let's take a look at the results presented in the actual study.
Cancer mortality trends
Let's begin by looking at the trend lines presented in the study.
The first thing we notice is that the lines track the time between diagnosis and death. The more time that elapses between the two events, the more favorable the curve. But, and this is something the medical community brags about, if you are detecting cancer early in its development through more frequent screening, then by definition you will have a longer time between diagnosis and death even if your treatment makes not a whit of difference in the final outcome. Thus earlier detection will create a more favorable graph even if you aren't living longer. Add to that the fact that some drugs such as Avastin are now extending survival by several months with some cancers (even if it does cause perforations in the colon), and the graph looks even better. So off the top, the claims that 650,000 deaths have been prevented represents, at least to some degree, a distortion of reality.
The next thing we notice is that mortality rates in the US really did peak in the early 90's and have dropped every year since. In fact, since 2000, the incidence and mortality rates for cancer in men have dropped about 1.8% a year -- in women, about .5% a year. Incidentally, this brings up a major red flag in the study: the disparity between men and women. But we'll talk more about that later. For now, though, let's focus on the overall trend line. I'm sure you're all familiar with the expression, "You can't see the forest for the trees." Unfortunately, this is an example, where the researchers decided not to show you the whole forest, but instead focus your attention on the prettiest trees. When you look at the bigger picture, it's nowhere near as pretty.
Source: US Mortality Data, 1930-2006, National Center for Health Statistics, Centers for Disease
Control and Prevention, 2009.
Taking a longer term, whole forest perspective, we can now see that mortality rates for cancer have actually increased geometrically over the last 75 years, with only the smallest of dips in the last 15. In fact, cancer rates have climbed between 800 and 1700% during this timeframe, depending on whose statistics you use. This is a number that far transcends any increase that might be accounted for by population increase, the aging of the population, or even better detection. But most important of all, this huge increase in mortality rates happened during a timeframe in which the medical establishment prevented anyone outside their fraternity from providing care for cancer patients -- under fear of imprisonment. In fact, even today, it is still illegal in half the states in this country for even a medical doctor to use any form of treatment not sanctioned by the medical community. The bottom line is that if the medical community wants to take ownership of the downturn in cancer deaths since the early 90's, they must also take ownership of the half century before then when mortality rates climbed through the roof. If you do that, you're no longer talking about 650,000 lives saved; you're talking about millions of lives lost. But that's a much less sexy news headline.
Mortality trends by types of cancer
As we delve deeper into the study's data, we can see that overall cancer death rates decreased in men by 19.2% between 1990 and 2005, with decreases in lung (37%), prostate (24%), and colorectal (17%) cancer rates accounting for nearly 80% of the total decrease. Among women, overall cancer death rates between 1991 and 2005 decreased by 11.4%, with decreases in breast (37%) and colorectal (24%) cancer rates accounting for 60% of the total decrease. An interesting anomaly is that the percentage of deaths from lung cancer in women (the single largest killer of women at 27%) did not decrease during that timeframe. In fact, it increased. This too is an important red flag that we will discuss further in a moment.
But first we need to challenge one of the study's underlying assumptions. Is the drop in cancer mortality (such as it is) actually driven in large part by better prevention, increased use of early detection practices, and improved treatments for cancer? Or are there other possible explanations for the drop that are just as likely…if not more so? Let's take a look at the key cancers and see.
Lung cancer and smoking
Every year the Gallup Organization takes a survey of the smoking habits of the adult American public. They have been doing this for 60 years. The first ever Gallup poll on this question, back in 1944, showed that 41% of Americans reported smoking. Today, that figure is about 21%. This is great news with five caveats.
- Most of that drop has been among men. At one time, smoking was almost exclusively a male dominated sport. Today it is a coed activity. This fact alone accounts for the fact that cancer mortality rates have dropped so much less in women than men -- particularly as can be seen in lung cancer. And that, of course, explains why lung cancer mortality rates have not dropped equally in women for men and women as we discussed above.
- The negative health effects of smoking usually take several decades to hit -- as do the benefits of quitting smoking.
- The prevalence of smoking is no longer dropping and seems to have leveled off at about 21% in the US. But with many more movie stars and rock musicians taking up the habit and serving as role models for young people around the world, it may be poised to begin moving upward once again.
- Smoking rates are increasing significantly around the world -- particularly in developing countries such as China, where as many as 70% of all adult men now smoke heavily. This means another huge spike in cancer rates worldwide will be coming over the next 20-30 years, starting now.
- Medical treatments for lung cancer are pretty much futile. In fact, even using all medical treatments available, average five year survival rates for lung cancer patients is only about 15%. Any drop in deaths from lung cancer has to come from reductions in smoking, not treatment.
Incidentally, according to the CDC, smoking is responsible for about 157,000 deaths from lung cancer annually in the United States -- but is actually responsible for 443,000 deaths of all kinds each year. Now it's true that most of those deaths are related to cardiovascular issues and non-cancerous lung diseases such as emphysema and COPD. On the other hand, a noticeable number of cancers such as lip, tongue, and throat cancer are closely connected to smoking. But these aren't major statistical killers. What about colon cancer, prostate cancer, and breast cancer? Death from these cancers has dropped noticeably too. Does the decline in smoking affect those mortality rates too?
Surprise, surprise, surprise! A study from the American Cancer Society found that indeed there is a substantial connection between smoking and colon cancer. Male smokers were found to have a 34% higher risk of dying from colon cancer. Female smokers in the study had a 43% higher risk of death. That means that a 50% reduction in smoking rates in the US would have a substantial impact on colorectal cancer rates, the second leading cause of deaths from cancer in men and women combined.
This would substantially explain why the mortality rates from colorectal cancer have dropped so significantly over the last few years -- but not completely. Is improved medical care the only explanation for the rest of the drop? Not at all! As it turns out, as smoking has declined in the US, there has been a concomitant rise in the popularity of dietary supplements. In fact, during the last decade the use of alternative medicines, particularly herbal products, has increased considerably. In 2001, Americans spent $4.2 billion on herbs and other botanical remedies -- rising to an estimated $6 billion in 2008. In fact, a conservative 50% of Americans now use supplements of some kind on a daily basis. Perhaps this too has some impact on the reduced mortality rates from cancer. I realize the medical community would disagree, and in fact, it was not even mentioned in the American Cancer Society Study cited at the top of the newsletter. But a reasonable person might ask if a sea change in the nutritional habits of 50% of the country might have some impact on health and mortality rates? It's certainly a possibility.
In any case, we can explain the biggest part of the improvement in mortality rates in the two leading cancer killers (lung and colon) as having nothing to do with medical care at all. Does that mean that improved medical care has had no impact? Not at all! There's no question that discovering colon cancer at a very early stage and removing it can pretty much end that manifestation of the cancer. And thus you remain cancer free until such time as your body chooses to manifest the cancer again -- either as colon cancer or some other form. The problem is that simply removing the cancer, or poisoning your body with chemotherapy drugs does not change the underlying conditions in your body that caused the cancer to manifest in the first place.
Think about this for a moment since your doctor won't -- if you don't change the underlying conditions that caused your body to manifest cancer in the first place, the odds that it will manifest cancer again sometime down the road are high. Surgery, radiation, and chemo do not change underlying conditions. They merely work on the immediate manifestation.
For years, it was thought there was no connection between prostate cancer and smoking, but in fact there appears to be one. It's not necessarily that large, and it's certainly not enough to account for the entire drop in prostate cancer deaths seen in men. So we need to look elsewhere.
And it would seem that the primary factor in the increased incidence of prostate cancer is the tremendous increase in chemical estrogens released into the environment. In addition, as testosterone levels drop with age, there is, in many cases, a concomitant rise in estradiol levels -- the major reason that many older men develop breasts. What makes estradiol so insidious is that it has a particular affinity for prostate tissue. And just as with women and breast tissue, estradiol stimulates cell growth in men too (in their prostates) and is potentially cancerous. This, then, is one of the main factors involved in the dramatically increased incidence of prostate cancer. Estradiol stimulates the BCL2 gene, which is the gene responsible for stopping cell death. What at first glance sounds like a positive is, upon closer inspection, not. When cell death in prostate tissue is blocked, cell growth continues unabated, becoming a major contributing factor in the enlargement of the prostate and the development of prostate cancer.
And that's why exposure to xenoestrogens (petroleum based chemical estrogens, potent in amounts as small as a billionth of a gram) offers a likely explanation as to why the incidence of prostate cancer has increased so dramatically over the last few decades; but what explains why the mortality rates have dropped? Is there any explanation other than improved medical care that can explain it? And the answer, once again, is yes. We've already mentioned the huge increase in the sale of herbal and dietary supplements. And in fact, men's prostate formulas containing ingredients such as Saw palmetto, Nettles, Pygeum Africanum, and pollen extract account for a large chunk of those sales. So once again, a reasonable person must ask if millions of men suddenly using such formulas might have some impact on the incidence and mortality rates vis-a-vis prostate cancer. And again, one must answer, "It's certainly a possibility." And once again, surgery, chemotherapy, and radiation get to pick up the pieces -- thus accounting for a small part of the improvement.
As with prostate cancer, the primary factor in the huge increase in breast cancer we've seen over the last few decades is exposure to chemical estrogens in the environment. And once again, improved medical treatment is not the only viable explanation for the drop in mortality rates. Sales of all-natural progesterone crèmes have literally exploded since Dr. John R. Lee published his first book on the subject over a decade ago. A reasonable person must once again assume that this has had in impact.
You trust your doctor, don't you?
Before I conclude this newsletter, there's one other thing I should mention. When it comes to doctors being on the right side of supplements and lifestyle impacting your health, it's worth noting that they are, at best, late comers to the game -- and at worst, frequently on the wrong side of the issue. Let me give you an example immediately at hand. As we've explained in some detail in this issue, smoking is one of the primary factors determining both the incidence and mortality rates from cancer. So what's the problem? Doctors are opposed to cigarettes, are they not?
And the answer is yes, they are "now." But back just a few decades ago, when the alternative health community was screaming about the dangers of smoking, the medical community…not so much. In fact, for a time, many medical doctors were actually promoting cigarette smoking as an aid to weight loss. Let me repeat that. For a time, many medical doctors were actually promoting cigarette smoking as an aid to weight loss. And it wasn't just doctors. The American Medical Association and the American Cancer Society refused to take an anti-smoking position until it was literally forced upon them. For those of you who are old enough think back. Remember?
Quite simply, doctors are experts when it comes to doctoring. They are not experts when it comes to diet, nutrition, supplements, and alternative therapies. Asking a doctor for advice or impartiality when it comes to these issues is like asking an National Football League owner what he thinks of professional soccer. The bottom line is that there are many things that doctors do well. If you're in an automobile accident, you want a medical doctor to put you back together, not an herbalist. But when it comes to issues of diet, environment, and supplements as they relate to health, the medical community is at best woefully ignorant, and at worst highly biased against giving you the information you need to optimize your health.
650,000 deaths avoided -- not necessarily
When it comes to cancer, we live in very barbaric times what with doctors choosing to cut, burn, and poison it out of your body. A hundred years from now, people will be appalled when they read how we treated cancer in 2009. And in fact, some very interesting therapies such as vaccinations that stimulate your immune system to fight cancer are in testing and right around the corner. The future may be closer than we think. But for now, the medical community is doing so badly. As the study itself points out, cancer still accounts for more deaths than heart disease in persons younger than 85 years of age. It is only by distorting the numbers, as we have seen, that the medical community gets to claim 650,000 lives saved. When dealing with medical statistics, I am always reminded of Benjamin Disraeli, the former Prime Minister of England, who was reportedly fond of saying, "There are three kinds of lies in the world: lies, damn lies, and statistics."
Unfortunately, when dealing with cancer, playing games with statistics can lead to death -- as it often does in the US and throughout the world. If you don't want to be just another statistic, you might want to look at alternatives. If you have not already done so, you might want to listen to my talk on the issue, Cancer, the Big Lie.